title: Determinants of lower extremity amputations: an institutional experience.
abstract: OBJECTIVE
  To determine the determinants of lower extremity amputations in diabetics and non-diabetics in a tertiary care institute.
  
  
  METHODS
  Cross-sectional, analytical study.
  
  
  METHODS
  Outpatients Department of the Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, from January 2007 to December 2010.
  
  
  METHODS
  All patients with amputations reporting at the study centre for prosthesis fitting were included in the study. Patient`s age, level of amputation, stump complications and associated risk factors of amputation were recorded on a structured proforma. Prosthesis and orthotic assessment were carried out. The frequency and determinants were collected to compare diabetic and non-diabetic amputees. The data was analyzed in SPSS windows version 16.
  
  
  RESULTS
  A total of 1091 subjects were provided prosthesis, including 847 males (77.6%). Mean age in diabetic and nondiabetics being 49.6 ± 15.2 and 26.6 ± 17.9 years respectively which is significant at (p < 0.001). Socioeconomic status and educational levels were significantly associated with diabetic status (p < 0.001). Amputation was more common in non-diabetic 858 (78.6%) compared to diabetics 233 (21.4%).
  
  
  CONCLUSIONS
  This study has identified that most common and significant predictors were gender, low social status and educational levels. Other significant predictors of amputation identified were type of lesion, (infections and ischaemia), initial diagnosis acute/chronic arterial insufficiency and diabetic foot.
authors.affiliation: Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi.
authors.forename: Nabila
authors.initials: N
authors.lastname: Soomro
authors.forename: Mahjabeen
authors.initials: M
authors.lastname: Khan
authors.forename: Syed Imran
authors.initials: SI
authors.lastname: Ahmed
authors.forename: Muhammad Ali
authors.initials: MA
authors.lastname: Minhas
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D000674:Amputees / Q000534:rehabilitation / Q000706:statistics & numerical data; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult